Impact of emergency department discharge stream short stay unit performance and hospital bed occupancy rates on access and patient flowmeasures: A single site study

Indonesia’s current hospital bed to population ratio of 6.3/10 000 population compares unfavourably with a global average of 30/10 000. Despite low hospital bed-to-population ratios and a significant “double burden” of disease, bed occupancy rates range between 55% - 60% in both government and private hospitals in Indonesia, compared with over 80% hospital bed occupancy rates for the South-East Asian region. Annual inpatient admission in Indonesia is, at 140/1 0 000 population, the lowest in the South East Asian region. Despite currently low utilisation rates, Indonesia’s Human Resources for Health Development Plan 2011-2025 has among its objectives the raising of hospital bed numbers to 10/10 000 population by 2014. The authors examined the reasons for the paradox and analysed the following contributory factors; health system’s shortcomings; epidemiological transition; medical tourism; high out-of-pocket payments; patronage of traditional medical practitioners, and increasing use of outpatient care. Suggestions for addressing the paradox are proposed.

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Hospital bed occupancy rates in England reach dangerously high levels

BMJ ◽

10.1136/bmj.n2079 ◽

2021 ◽

pp. n2079

Author(s):

Adrian O’Dowd

Keyword(s):

Bed Occupancy ◽

Hospital Bed ◽

Occupancy Rates ◽

Bed Occupancy Rates

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Impact of Electronic Health Records on the Hospital Bed Occupancy Rates in Surgical Units in France: Results from the E-SI (PREPS-SIPS) Study

Athens Journal of Health ◽

10.30958/ajh.3-1-1 ◽

2016 ◽

Vol 3 (1) ◽

pp. 11-26 ◽

Cited By ~ 1

Author(s):

Morgane Plantier ◽

Nathalie Havet ◽

Nicolas Caquot ◽

Pierre Biron ◽

Camille Amaz ◽

...

Keyword(s):

Electronic Health Records ◽

Bed Occupancy ◽

Health Records ◽

Surgical Units ◽

Hospital Bed ◽

Electronic Health ◽

Occupancy Rates ◽

Bed Occupancy Rates

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Nowcasting for improved management of COVID-19 acute bed capacity

British Journal of Healthcare Management ◽

10.12968/bjhc.2020.0179 ◽

2021 ◽

pp. 1-3

Author(s):

Richard M Wood

Keyword(s):

Strategic Planning ◽

Healthcare Services ◽

Bed Occupancy ◽

Bed Capacity ◽

Occupancy Rates ◽

Second Wave ◽

Bed Occupancy Rates

As the second wave of COVID-19 continues to push healthcare services to their limits, rapid and strategic planning has never been more important. Richard M Wood explains how statistical ‘nowcasting’ can be used to predict bed occupancy rates and help leaders to better manage acute capacity during this ongoing crisis.

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Milburn promises to cut NHS bed occupancy rates

Nursing Standard ◽

10.7748/ns.16.7.5.s9 ◽

2001 ◽

Vol 16 (7) ◽

pp. 5-5

Author(s):

Christian Duffin ◽

Bill Doult

Keyword(s):

Bed Occupancy ◽

Occupancy Rates ◽

Bed Occupancy Rates

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Bed Occupancy Rates and Hospital-Acquired Clostridium difficile Infection: A Cohort Study

Infection Control and Hospital Epidemiology ◽

10.1086/673156 ◽

2013 ◽

Vol 34 (10) ◽

pp. 1062-1069 ◽

Cited By ~ 5

Author(s):

Lauren C. Ahyow ◽

Paul C. Lambert ◽

David R. Jenkins ◽

Keith R. Neal ◽

Martin Tobin

Keyword(s):

Cohort Study ◽

Clostridium Difficile ◽

Significant Risk ◽

Organizational Factors ◽

Economic Benefits ◽

Bed Occupancy ◽

Increased Risk ◽

Hospital Acquired ◽

Occupancy Rates ◽

Bed Occupancy Rates

Background.An emergent strain (ribotype 027) of Clostridium difficile infection (CDI) has been implicated in epidemics worldwide. Organizational factors such as bed occupancy have been associated with an increased incidence of CDI; however, the data are sparse, and the association has not been widely demonstrated. We investigated the association of bed occupancy and CDI within a large hospital organization in the United Kingdom.Objective.To establish whether bed occupancy rates are a significant risk factor for CDI in the general ward setting.Methods.A retrospective cohort study was carried out on data from 2006 to 2008. Univariate and multivariate Cox regression modeling was used to examine the strength and significance of the associations. Variables included patient characteristics, antibiotic policy exposure, case mix, and bed occupancy rates.Results.A total of 1,589 cases of hospital-acquired CDI were diagnosed (1.7% of admissions), with an overall infection rate of 2.16 per 1,000 patient-days. Median bed occupancy was 93.3% (interquartile range, 83.3%–100%) Univariate and multivariate analyses showed positive and statistically significant associations. In the adjusted model, patients on wards with occupancy rates of 80%–89.9% had rates of CDI that were 56% higher (hazard ratio, 1.56 [95% confidence interval, 1.18–2.04]; P<.001) compared with baseline (0%–69.9% occupancy). CDI rates were 55% higher for patients on wards with maximal bed occupancy (100%).Conclusions.There is strong evidence of an association between high bed occupancy and CDI. Without effective interventions at high levels of bed occupancy, the economic benefits sought from reducing bed numbers may be negated by the increased risk of CDI.

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Patients with acute stroke are less likely to be admitted directly to a stroke unit when hospital beds are scarce: A Swedish multicenter register study

European Stroke Journal ◽

10.1177/2396987317698328 ◽

2017 ◽

Vol 2 (2) ◽

pp. 178-186 ◽

Cited By ~ 4

Author(s):

David Darehed ◽

Bo Norrving ◽

Birgitta Stegmayr ◽

Karin Zingmark ◽

Mathias C. Blom

Keyword(s):

Emergency Department ◽

Confidence Interval ◽

Acute Stroke ◽

Odds Ratio ◽

Stroke Unit ◽

Bed Occupancy ◽

Hospital Beds ◽

Hospital Bed ◽

Direct Admission

Introduction It is well established that managing patients with acute stroke in dedicated stroke units is associated with improved functioning and survival. The objectives of this study are to investigate whether patients with acute stroke are less likely to be directly admitted to a stroke unit from the Emergency Department when hospital beds are scarce and to measure variation across hospitals in terms of this outcome. Patients and methods This register study comprised data on patients with acute stroke admitted to 14 out of 72 Swedish hospitals in 2011–2014. Data from the Swedish stroke register were linked to administrative daily data on hospital bed occupancy (measured at 6 a.m.). Logistic regression analysis was used to analyse the association between bed occupancy and direct stroke unit admission. Results A total of 13,955 hospital admissions were included; 79.6% were directly admitted to a stroke unit from the Emergency Department. Each percentage increase in hospital bed occupancy was associated with a 1.5% decrease in odds of direct admission to a stroke unit (odds ratio = 0.985, 95% confidence interval = 0.978–0.992). The best-performing hospital exhibited an odds ratio of 3.8 (95% confidence interval = 2.6–5.5) for direct admission to a stroke unit versus the reference hospital. Discussion and conclusion We found an association between hospital crowding and reduced quality of care in acute stroke, portrayed by a lower likelihood of patients being directly admitted to a stroke unit from the Emergency Department. The magnitude of the effect varied considerably across hospitals.

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ANALYSIS OF STRUCTURE AND FUNCTIONING OF HOSPITAL BEDS OF EMERGENCY DEPARTMENT IN THE RUSSIAN FEDERATION

EMERGENCY MEDICAL CARE ◽

10.24884/2072-6716-2019-0-3-4-9 ◽

2019 ◽

Vol 20 (3) ◽

pp. 4-9

Author(s):

S. F. Bagnenko ◽

A. G. Miroshnichenko ◽

R. R. Alimov ◽

N. V. Razumnyj ◽

I. A. Turov

Keyword(s):

Emergency Department ◽

Russian Federation ◽

Occupancy Rate ◽

Short Stay ◽

Bed Occupancy ◽

Hospital Beds ◽

Discharged Patients ◽

Bed Capacity ◽

The Russian Federation ◽

Population Ratio

29 emergency departments (ED) with hospital beds were functioning in 2018 in the Russian Federation (RF). Within the period 2014–2018 the bed capacity has been increased from 415 to 737, which portion is increased from 0,036% to 0,071% (in 2018 the portion of daily bed was 27,3%, the portion of the bed of short stay department was 72,7%). The number of discharged patients has been increased from 94545 to 306757. Therewith the portion of patients referred from ED to specialized units has been decreased from 19,0% to 11,1%. The average annual bed occupancy rate is 276,6 and 274,1. The bed turnover has been increased from 262,6 to 447,2. The lethal index is decreased from 0,18% to 0,13%. Bed population ratio keeps at the low level (5.0 bed per 1 million people which is rated as 4,5% from recommended values). Additional introduction of hospital departments of emergency medicine in 56 federal subjects of the RF allows quicker to achieve the goals of the National Project «Health care».

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